Benign Breast Disease Flashcards
What is fibroadenoma?
Benign overgrowth of collagenous mesenchyme of one breast lobule
Common in women under 30
No increased risk of malignancy
How does firboadenoma present?
Firm smooth mobile lump
Breast mouse
Painless, non-tender
May be multiple
What is management for fibroadenoma?
Observation and reassurance - no increased risk of malignancy
USS if in doubt
If >3cm surgical excision is usual
Phyllodes tumours should be widely excised
Who does breast cyst occur in ? What are features of breast cyst? Management?
Common >35 years, especially perimenopausal
Benign fluid filled smooth discrete lump.
May be fluctuant
Not fixed
Occasionally painful
Cysts should be aspirated, those which are blood stained or persistently refill should be biopsied or excised
Small increased risk of breast cancer
What is sclerosing adenosis/fibroadenosis? Features? Management?
Breast lump or breast pain
Causes mammographic changes which may mimic carcinoma
Causes distortion of the distal lobular unit
Considered a disorder of involution - no increased risk of malignancy
BIopsy
What is infective mastitis/breast abscess? Organism? Features? Management?
Infection of mammary duct often associated with lactation
Staph. aureus
Abscess presents as painful, hot swelling of breast segment
Antibiotics
Open incision or percutaneous drainage if abscess
What is duct ectasia? Features of duct ectasia? Management?
Typically occurs around menopause
Ducts become dilated and shortened and blocked and secretions stagnate
Nipple discharge (creamy/green/brown/bloody) ± nipple retraction ± lump
Refer for confirmation of diagnosis
Usually no treatment needed
What is breast fat necrosis? Features? Management?
Fibrosis and calcificaiton after injury to breast tissue
Scarring results in a firm irregular lump
Refer for triple assessment
Occurs in obese women with large breasts
No Mx once confirmed
What is duct papilloma? Features?
Local areas of epithelial proliferation in large mammary ducts
Hyperplastic lesions rather than malignant or premalignant
Blood stained discharge
No increased risk of malignancy
What is mastitis? Management? ABX indications?
Inflammation/infection of the breast tissue
Continue breast feeding
IF systemically unwell
Nipple fissure present
Symptoms do not improve after 12-24h of effective milk removal
Use flucloxacillin for 10-14 days
What is epithelial hyperplasia? Features? Management?
Generalised lumpiness or discrete lump
Increased cellularity of temrinal lobular unit
Atypical features and FHx of breast cancer confers greatly increased risk of malignancy
